Patient Participation Report 2013-2014

Wordsworth Health Centre

1: The History of the Patient Reference Group and the Patient Participation Report 3

2: Steps taken to determine and reach agreement on issues of priority for Practice Survey 4

3: The Practice Survey: Results, Actions and the PPG 5

4: The Action Plan– Summary 15

6: Publication and Update on previous action plans 17

7: Opening hours & method of obtaining access to services during core hours 19

8: Extended Hours Access Scheme 19

Appendices

Appendix 1 –PPG meeting minutes Oct 13 20

Appendix 2- PPG meeting minutes Nov 13 21

Appendix 3-PPG meeting minutes Jan 14 23

Appendix 4- Form for wider patient population 25

Appendix 5- Practice Survey 26

1:The History of the Patient Reference Group and the Patient Participation Report

2013-2014 saw year 3 of the Patient Reference Group known as the Wordsworth Patient Participation Group and the Patient Participation Report. Copies of the previous two Patient Participation Reports and minutes of meetings can be found on the practice website under Patient Participation.

The official membership of the group is the same as Year 2 and is comprised of registered patients. It was decided to close further entry into the group in order to maintain a manageable level of participation however, during the year a smaller core group emerged as several official members failed to attend meetings. It has recently been discussed (see Minutes January 2014/Appendix 3) to write to members who have stopped attending and to reopen membership of the group. The group are particularly interested in getting some younger members as it is felt they have not been well represented and so some publicity advertising the group will be designed specifically to appeal to young people. The remaining core group currently consists of about 50% retired and 50% working people. The gender balance slightly favours males and the group have a variety of health conditions.The number of meetings increased during 2013-2014 and 6 very lively meetings were held.

The composition of the group is currently as follows:

Ethnicity / No of members / Ethnicity / No of members
African / 2 / Indian / 5
Caribbean / 1 / Pakistani / 2
British / 3 / Other White / 1
Gender / No of members
Male / 7
Female / 7
Age Group / No of members
45-54 / 4
55-64 / 4
65-74 / 6

As the Patient Participation & Complaints Manager I have attended meetings, discussed the practice survey, ensured the smooth running of meetings, taken minutes when required and liaised with wider practice staff. The Chair and Vice-Chair have both chaired meetings and have shown praise-worthy dedication and commitment to their roles and provide a strong focal point for the core group

2: Steps taken to determine and reach agreement on issues of priority

for the Practice Survey

The initial steps taken for this year’s practice survey were taken at the October meeting of the Patient Participation Group (PRG) (See appendix 1). The PPG was informed that we would need to consider the following information as possible sources for questions on this years practice survey ie Complaints, Suggestion Box comments, Practice perspective, PPG perspective. Wethen produced a list of the main areas of concern.

I further explained that we needed to produce a short form asking for patient views about what they think should be on the survey and that we should use that information to select and prioritise the questions we would need to ask. They decided that I would produce a simple tick box form for patients and that they would then select the areas to focus on by seeing what items were ticked more frequently by patients. We went on to discuss the wording suggested by the Department of Health in explaining this to patients and the group decided to simplify it and produce their own wording (see Appendix 4 for the form produced). The group discussed how this form would be made available in order to optimise the number of responses and dates were set for this to be executed.

The final version of the form was agreed by email and the results were distributed before the next meeting which was on November 14th. The results I distributed to the PPG are shown below.

Information for Practice Survey

Making Appointments / 15
Referrals to other hospitals and organisations / 5
Prescriptions / 6
Opening Times & Days / 4
Staff Attitude / 3
Communications & Messages between patients & staff eg test results / 4
Facilities for people with disabilities and mobility issues / 2
Information to patients about the practice / 1
Queuing at reception / 3
Other services at the practice eg CBT, Physiotherapy / 2

From this information it became clear that the three main areas to focus on would be Appointments, Referrals and Prescriptions. At the November meeting of the PPG the main areas were agreed and the group agreed the type of questions they wanted to see on the survey, the number of questions that should be asked as well as the credibility of the survey methodology. (See Appendix 2/ November 14th Minutes of meeting)

Over the next two weeks I circulated examples of questions and got comments from the group. The final version of the survey was agreed via email and the survey was carried out in December 2013 (See Appendix 5/ Practice Survey 2013-2014)

The Practice Survey – Results, Actions and the PPG

The initial results of the survey were collated and both statistical information and written comments were presented to the PPG at their January meeting. A number of proposed actions came from the group.( See Appendix 3,Minutes of Meeting January 15th)After the meeting a final version of the practice survey was produced.This was published on the website in February 2014 and included graphs, statistics, patient comments and actions. The graphic representation of the survey was also displayed in two places; near the front door and in the waiting area. The full document which is available on the intranet is copied below:

Practice Survey 2013 -2014

Booking an appointment

Comments about the telephone system

(Please note some of the lengthier comments have been summarised and some comments amended to remove identifiable details)

Time taken to phone

Engaged then long queue by the time my turn had come the appointment had gone, constantly tried for 2 weeks
Sometimes frustrating as I can’t get through for 15-20mins
Difficult never get through
Easy sometimes but most times have to wait upto 15-20 mins
The phone is constantly busy
Not so easy as I have to ring back many/several times before I got to speak to a receptionist because of getting the engaged tone each time it rings
Difficult because it is always busy and sometimes 100’s of calls to reach and talk to receptionist and then they decide yes or no, so frustrating, like racing to make a call
Sometimes it is difficult depends on how busy doctor is
Appointment system should be improved, mostly I had to call 70-80 times at 8:00am to get through
Appointment systems need to be improved. I call from 8:00 in the morning and by the time I get through 8:10 all appointments are gone
Difficult because cannot get through, always busy

Phoning at 8:00 am

Carers responsibilities as well as travelling to work
Its hard for me to call in the morning
Difficult as I am generally en route
Automated system should work anytime of day not only before 8:00
Extremely difficult to get an appointment by phone at 8:00am. The automated service does not work. Restrictions on only being able to book an appointment at 8:00 for next day or @17:00 for on a Wednesday for a Saturday appt.
The period for making an appointment in the morning is narrow. The time slot needs to widen up
Booking window too small

Expense of phone call

-This is sometimes impossible waiting so long on the phone for simple appointment time and cost of calls and so long message on GP phone, no need to listen to messages
It’s quite early and always takes long to get through. It’s not easy. Moreover telephone is expensive
Your current appointment system is not for working people. Booking appointments from pay as you go mobile is very expensive to get through it takes at least 15 minutes and after that it’s like winning the lottery!!! If you are lucky.

Issues for working people

Been here 50 years at least. Can see trying to improve things all the time. Sometimes hard to get 9 am appointment which is easier when working
I find booking an appointment extremely difficult especially when I don’t have access to a phone while Im at work
Need to make more facility for emergency appointments for working people ie shift work

General appointment issues

Please try and change appointment system
They must give you an appointment when you need it
I was totally happy when I first registered but lately have been disappointed. I can hardly get an appointment with a specific GP or sometimes any GP.
The automated system doesn’t work with this time slot. I’ve been asked by doctors to come back and see them after a certain time but it has been impossible to see any of them so my treatment is left hanging
The appointment system is not very good, it should change and also the system dealing with complaints is very unsatisfactory
Need more telephone lines so people can get through easy, not everyone wants to speak to an automated system
The only problems I face here are to book an appointment apart from that all other things are very satisfied
I would be happier to recommend if booking advance appointments were a tad easier, booking 7 days in advance rather than one day in advance.
Difficult as you cannot predict being ill the next day,calls inundated as only booking time available elderly people are inconvenienced

Actions to be taken

Telephone message to be shortened, improved and update by Practice Manager and Dr Goodyear to be completed by end of June 2014

Review of online access by the Practice Manager and Operations Manager by end September 2014

Review of access and appointment system by Practice Manager and GP’s by September 2014

Installation of additional phone lines managed by the Practice Manager by April 2014

Review of telephone GP triage appointments by Practice Manager by December 2014

Prescriptions

Comments about Prescriptions

(Please note some of the lengthier comments have been summarised and some comments amended to remove identifiable details)

Doctor prescribed medication which was no longer manufactured for years
Been told to buy over the counter when I am entitled to NHS prescription (was more expensive over the counter) and it is an ongoing prescription needed for several months a year

Actions to be taken

Clear notice to be displayed indicating precisely what 48 hours means ie working days not including weekend. For example, prescription requested by 1:00pm on Friday to be collected after mid-day on Tuesday to be done by Operations Manager by end March 2014

Review of online repeat prescribing requests Practice Manager and Operations Manager by end September 2014

Referrals

Comments about referrals

(Please note some of the lengthier comments have been summarised and some comments amended to remove identifiable details)

Waited 6 weeks for appointment NUHT
MRI scanning is always busy
Ultra sound at Newham Hospital/ if you visit the hospital in person you can leave with a booked appointment later the same day but if the practice fax it then it can take a month to receive a response
3 separate referrals sent to wrong organisations on separate occasions all of which I had to chase up. One fax sent to wrong number. One organisation did not receive my details or medical records therefore my appointment was delayed due to practice incompetence and lack of care. The practice is incapable of keeping up-to-date contact details of medical institutions. Mistakes continue to be made despite a number of complaints to the practice.
At hospital I have to wait 2-3 months for an appointment
My pain clinic booked an appointment for me then cancelled it without informing me. Then I had to be referred to the Pain Clinic again.
Referral was asked for on 3/10/13 on 29/11/13still no appointments
I had been waiting for almost 3 months for appointment for my daughter. I made a query and got to know referral was not sent or no referral was made

Actions to be taken

Clear notice to be on display in every Doctors consulting room stating that if the patient has not heard back from organisation to which they have been referred within a specific time frame then they should inform the doctor by Operations Manager by end of March 2014

Levels of satisfaction

Comments about levels of satisfaction

(Please note some of the lengthier comments have been summarised and some comments amended to remove identifiable details)

Reception staff

Receptionists should be a bit helpful and their attitude towards patients should be changed. Sometimes they seem very irritated and ignore the person in front of them. They are there behind the reception area to help us not to look at the monitor screen and act they are very busy. We the patients are also very busy in our personal life.
(Name withheld) is best receptionist, most of them are good.
Very pleasant and helpful staff
Very friendly staff and helpful
Receptionists need to understand that people have difficult circumstances
Very happy with staff but not very happy with automated system
Staff tend to be helpful
Reception telephone number repeatedly on silent tone and not answered

Doctors

Doctors are good
Need to have more Doctors. Dr (name withheld) is very pleasant and helpful. Dr (name withheld) is good. I miss Dr (name withheld), he was very good doctor
Need more GPs like Dr (name withheld) and Dr (name withheld) – 2 top gentleman, very professional and caring.
People that work in this clinic are really appreciated. Especially Dr (name withheld) for identifying my TB. If I compare it with another clinic this surgery is very good.
In GP is not so many doctors, that would be possible to give for continuity a very good service

Waiting to be seen

I answered ok due to several occasions I have had to wait for over an hour to be seen sometimes just for an injection
When you come for an appointment and your turn comes you often have to wait long

Overall experience

I have good experience at this surgery always treated very well
Again Im always thankful to doctors and people working in this clinic.
It would be great if there was a better blood taking service
I am very happy and satisfied with your services
Poor handling of medical records
Letter sent claiming a verbal communication had been made but untrue
No faith in management or patient care, management seems uninterested in improvement or taking complaints seriously
Posters with out of date information about booking times left in waiting room
No consistency in information given out by staff

Actions to be taken

Publicise an explanation that it is often unavoidable that appointments are delayed due to the clinical nature of consultations on the electronic display board by the Operations Manager by end June 2014

Regular checks on posters and information displayed in waiting area. To be done by the Operations Manager start as soon as possible and reviewed on a monthly basis.

Positive feedback of good service to staff named in the survey. By Practice Manager at the next reception meeting in March 2014.

Participant profile

Are you male or female?

Male / 26.6%
Female / 70.4%

How old are you?

Under 18 / 0% / 55 - 64 / 6.6%
18 – 24 / 5% / 65 - 74 / 6/6%
25 – 34 / 28.4% / 75 - 84 / 3.3%
35 – 44 / 15% / 85 and over / 0%
45 – 54 / 31.7%

What is your ethnic group?

White

British / 11.6%
Irish / 5%
Any other white background / 3.3%

Mixed

White & Black Caribbean / 0
White & Black African / 1.6%
White & Asian / 0
Any other Mixed background / 0

Asian or Asia British

Indian / 28.4%
Pakistani / 26.6%
Bangladeshi / 6.6%
Any other Asian background / 3.3%

Black or Black British

Caribbean / 6.6%
African / 1.6%
Any other Black background / 0

Chinese or other ethnic group

Chinese / 0
Any other ethnic group / 1.6%

Are you currently in full or part-time employment?

Yes / 53.4%
No / 38.4%

How many times have you visited a GP at the Wordsworth Health Centre in the last year?

One visit (1) / 3.3%
Two visits (2) / 11.6%
Three visits (3) / 10%
Four to six visits (4-6) / 28.4%
More than six visits (6+) / 15%
Cant remember / 23.2%

The Action Plan Summary 2013-2014

Problem Identified / Proposed Action / Who / When
Cost of phone calls / Telephone message to be shortened, improved and updated / Practice Manager and Dr Goodyear / End of June 2014
Phone lines are too busy / Review of online access / The Practice Manager and Operations Manager / End of September 2014
(action completed March 2014)
Phone lines are too busy / Installation of additional phone lines / Practice Manager / April 2014
Problems getting appointments / Review of access and appointment system / Practice Manager and GPs / September 2014
Problems getting appointments / Review of telephone GP triage appointments / Practice Manager / December 2014
Expectation that 48 hours means 7 days a week / Clear notice to be displayed indicating precisely what 48 hours means ie working days not including weekend. / Operations Manager / End March 2014
Improve patient experience and convenience / Review of online repeat prescribing requests / Practice Manager and Operations Manager / End September 2014
Patients not hearing back from referrers within a reasonable time frame / Clear notice to be on display in every Doctors consulting room stating that if the patient has not heard back from organisation to which they have been referred within a specific time frame then they should inform the doctor. / Operations Manager / End of March 2014
Managing patient expectations about being kept waiting and not being seen at exact appointment time / Publicise an explanation that it is often unavoidable that appointments are delayed due to the clinical nature of consultations on the electronic display board / Operations Manager / End of June 2014
Out-dated information being displayed / Regular checks on posters and information displayed in waiting area. / Operations Manager / Start as soon as possible and reviewed on a monthly basis
Pass on positive feedback about staff / Positive feedback of good service to staff named in the survey. By at the. / Practice Manager / Next reception meeting in March 2014

Publication and Update on previous Action Plan

2012-2013 Action Plan Update (previously published in waiting room area)

Patient Participation Report 2013-2014